Venovenous haemodiafiltration for the management of dabigatran overdose in intensive care unit

• Published in: Clinical kidney journal Vol. 8; no. 2; pp. 199 - 201
• Main Authors: Claisse, Guillaume, Delavenne, Xavier, Masson, Ingrid, Maillard, Nicolas, Alamartine, Eric, Mariat, Christophe
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-04-2015
• Subjects: Contents; intensive care; dabigatran overexposure; haemorrhagic shock; haemodiafiltration
• ISSN: 2048-8505; 2048-8513
• DOI: 10.1093/ckj/sfv001

Dabigatran is a direct thrombin inhibitor indicated for thromboembolism prophylaxis in patients with non-valvular atrial fibrillation. The procedure to manage dabigatran-associated haemorrhages is not well formalized. Conventional haemodialysis has been evaluated with good results. Patients with dabigatran-associated bleeding may be unstable and convective techniques like venovenous haemodiafiltration (HDF) can be interesting. We report the case of a 74-year-old, critically ill patient with haemorrhagic shock and dabigatran overexposure due to acute kidney injury. He underwent HDF and dabigatran blood concentrations decreased from 325.3 ng/mL to 160.5 ng/mL. We report here key pharmacokinetics parameters (half-life, extraction coefficient, clearance).